消渴足浴方与足部穴位按摩治疗糖尿病周围神经病变的护理效果分析

吴丽珍　张征宇

[摘要] 目的 探讨消渴足浴方与足部穴位按摩治疗糖尿病周围神经病变的护理效果。 方法 选择2014年12月～2016年12月本院收治的糖尿病并发周围神经病变者80例，按照随机数字法分为观察组与对照组，各40例，对照组行常规干预，主要针对使用药物方法进行健康教育、加强对患者血糖监测的干预，运用饮食干预、情志调节等常规护理方法，观察组则针对使用消渴足浴方熏洗联合足部穴位按摩进行针对性护理干预，对所有患者入组前及出院时情况进行观察，比较干预后两组神经缺陷评分（NDS）变化情况，比较正中神经、腓神经传导速度，统计干预前后两组诺丁汉生存质量评分变化情况。 结果 干预后观察组踝反射、大拇指振动感觉、针刺感觉、温度感觉评分均显著低于干预后对照组（P<0.05），干预后观察组正中神经传导速度快于对照组（P<0.05），腓神经传导速度快于对照组（P<0.05），干预后，观察组诺丁汉生存质量评分显著高于干預前观察组与干预后对照组（P<0.05）。 结论 针对糖尿病周围神经病变患者行消渴足浴方联合足部穴位按摩治疗同时，进行有效的护理干预，能显著改善患者神经缺损状况，增强局部神经传导功能，提高患者生存质量。

[关键词] 消渴足浴方；熏洗；足部穴位按摩；糖尿病周围神经病变；护理

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2017）19-0142-04

[Abstract] Objective To explore the nursing effect of Xiaoke Zuyu Decoction and foot acupoint massage in the treatment diabetic peripheral neuropathy. Methods 80 patients with diabetes mellitus complicated with peripheral neuropathy who were admitted to our hospital from December 2014 to December 2016 were selected. According to the random number method， the patients were divided into observation group and control group， with 40 cases in each group. The control group was given routine intervention， who were mainly given health education by pharmaceutical methods， and the intervention on the monitoring of blood glucose was strengthened. Regular nursing methods such as diet intervention and emotional adjustment were applied. The observation group was given targeted nursing intervention by the application of Xiaoke Zuyu Decoction fumigation and washing combined with foot-bathing acupoint massage. The conditions before enrollment and upon discharge were observed in all patients. The changes of neurological deficit score （NDS） were compared after the intervention between the two groups， and the conduction velocity of median nerve and peroneal nerve were compared. The changes of the Nottingham's quality of life score before and after the intervention were statistically analyzed. Results After the intervention， the scores of ankle reflex， thumb vibration sense， needling sense and temperature sense in the observation group were all significantly lower than those in the control group（P<0.05）. The conduction velocity of median nerve in the observation group after the intervention group was faster than that in the control group（P<0.05）， and the conduction velocity of peroneal nerve was faster than that in the control group（P<0.05）. After the intervention， the Nottingham's quality of life score in the observation group was significantly higher than that before the intervention in the observation group group and that after the intervention in the control group（P<0.05）. Conclusion For the patients with diabetic peripheral neuropathy， application of Xiaoke Zuyu Decoction combined with foot acupoint massage therapy， as well as effective nursing intervention， can effectively improve the neurological deficits， enhance the local nerve conduction function and improve the quality of life of patients.

[Key words] Xiaoke zuyu decoction； Fumigation and washing； Foot acupoint massage； Diabetic peripheral neuropathy； Nursing care

糖尿病周围神经病变临床上将其归为糖尿病最常见且最复杂的并发症，其发病机制主要是因为慢性长期的血糖升高而导致的末梢神经系统损伤[1]，可累及全身各部位末梢神经[2]。研究称，超过60%糖尿病患者合并有周围神经病变。糖尿病周围神经病变发生率高，病程长且临床治疗效果不理想而被临床广泛重视[3]，临床表现上主要以感觉减退甚至丧失，肢体麻木等为主，严重者将出现自发性疼痛最终导致肢体运动功能障碍发生。随着糖尿病病程的延长，发生周围神经病变比例显著增加，给患者造成极大困惑同时增加本病致残率。……